Pharmacology Discussion Questions

This document contains discussion questions related to various topics in pharmacology. It covers neurotransmitters, drug effects, and treatment options for different conditions.

Running head: PHARMACOLOGY 1
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PHARMACOLOGY 2
Autonomic Discussion Questions
Name the neurotransmitter that is affected by benzodiazepines.
Benzodiazepines are anxiolytics that also affect cognizance, emotional response, motor
coordination, and consciousness. Benzodiazepines acts on the neurotransmitter, GABA (Gamma
Amino Butyric Acid).
Does the drug, named above, increase or decrease its effect(s)?
Benzodiazepines enhance the efficacy of the synaptic transmission of GABA by binding
to its receptors.
Describe status epilepticus? What drug class is used to treat this condition?
Status epilepticus is a neurological disorder that occurs when seizures last too long or
repetitively such that the patient does not recover within these episodes. The disorder can either
be convulsive or non-convulsive. Benzodiazepines such as diazepam are used to treat Status
epilepticus by bind to the benzodiazepines-GABA and barbiturate-receptor complex; therefore,
increasing the inhibition of the neurotransmitter.
List at least 5 symptoms of major unipolar depression. What are 3 side effects of SSRI
drugs?
Major unipolar depression is a mental health condition that affects both males and
females, but the females are at higher risk of developing the illness than men. The following
symptoms characterize it: psychomotor agitation or retardation; suicidal thoughts; sudden loss or
gain in weight; insomnia or hyperinsomnia; and loss of interest in daily activities. SSRI drugs are
used to treat major unipolar depression but have several side effects such as xerostomia,
drowsiness, and nausea (Sultana, Spina & Trifiro, 2015).

PHARMACOLOGY 3
Name the type of antidepressant that is best for the elderly depressed patient? Why is it
preferred?
Depression is a significant concern among the elderly, and it is essential that it is properly
diagnosed and treated. Untreated patients are likely to have suicidal thoughts, adverse health
conditions, and overall poor quality of life (Sultana, Spina & Trifiro, 2015). A patient’s
physiological heterogeneity determines their response to medication. The effective
antidepressants for the elderly are the selective serotonin reuptake inhibitors (SSRIs) since they
exhibit better tolerance and marginal side effects to a patient’s body (Sultana, Spina & Trifiro,
2015). For instance, citalopram, an SSRI, has diminished risks of pharmacokinetic interactions
since they have no effect a patient’s cytochrome P450 system.
List three symptoms of Parkinson’s Disease. Use the medical terminology.
Parkinson’s disease affects the brain’s capacity to coordinate movements. Individuals
with Parkinson’s disease have nerve cells that degenerate slowly and ultimately lose the ability to
produce dopamine: a chemical responsible for the control of movements (DeLong et al., 2014).
Patients with these disorder experience bradykinesia, which is the slowness of movement due to
fatigue and weakness (DeLong et al., 2014). Besides, most patients experience postural
instability due to failed brain reflexes that control balance. Also, the patients may experience
progressive muscle rigidity and stiffness that often causes cramping and discomfort.
Explain the effects of dopamine and acetylcholine on movement. What happens to these
neurotransmitters with Parkinson’s Disease?
The neurons in the substantia nigra are responsible for the production of dopamine, which
controls movement (DeLong et al., 2014). Patients with Parkinson’s disease have nerve cells that
die off minimizing the amount of dopamine produced. When the dopamine levels decrease, a

PHARMACOLOGY 4
patient may begin to experience stiffness, postural instability, and slow movements. Minimal
levels of dopamine increase the levels of acetylcholine that contributes to the motor symptoms
(DeLong et al., 2014).
List three major effects of stimulation of the sympathetic nervous system.
Sympathetic stimulation is part of the autonomous nervous system, which activates the
fight and flight mechanism (Mancia & Grassi, 2014). Sympathetic stimulation increases
heartbeat; increases blood pressure; and decreases the motility of the colon (Mancia & Grassi,
2014).
List three major effects on other organs systems from the stimulation of the
parasympathetic nervous system.
By contrast, parasympathetic stimulation is responsible for the “rest and digest” activities
(Mancia & Grassi, 2014. It stimulates digestion and lacrimation. Besides, it slows the heart rate
by decreasing the rate of diastolic depolarization.
List the neurotransmitters of the sympathetic and parasympathetic nervous system
The cholinergic nerves release the acetylcholine, a neurotransmitter involved in
parasympathetic stimulation. Similarly, the sympathetic nerves are responsible for the release of
epinephrine and norepinephrine.
What is acetylcholinesterase? What is its effect?
Acetylcholinesterase is an enzyme that is found in the neuromuscular junctions and
cholinergic synapses; it hydrolyzes acetylcholine and other choline esters into choline and acetic
acid.

PHARMACOLOGY 5
CNS 1& 2 Discussion Questions
Explain what it means if a drug is a “non-ceiling” drug.
Non-ceiling drugs have no upper limits to the dosage forms that can be administered to
patients who developed tolerance to previous doses. Some of these non-ceiling drugs include
methadone and morphine (Nielsen et al., 2016).
What is the mechanism of action of an opioid agonist?
Opioids act on the brain opioid receptors causing analgesia and anesthesia. Opioid
agonists fully activate the brain opioid receptors hence undergoing a significant conformational
change, which results in maximal opioid effects (Nielsen et al., 2016) Opioid agonists include
morphine and hydrocodone.
List at least three symptoms of opioid toxicity or overdose. What type of drug is used to
treat this?
Some of the symptoms of opioid toxicity include hypotension, sedation, and respiratory
depression (Nielsen et al., 2016). Such effects can be reversed by the administration of opioid
antagonists such as Naloxone, which displace the opiates from the brain opioid receptors
(Robison & Wermeling, 2014).
List at least 4 symptoms of opioid withdrawal. Name two types of drug treatment for
opioid withdrawal.
Opioid withdrawal refers to both mental and physical signs that occur after the last
dosage of opioids, and it may last for hours to weeks. Some of the withdrawal symptoms that
may develop include lacrimation, anxiety, piloerection, and diarrhea (Robison & Wermeling,
2014). To counter these symptoms, patients may be prescribed with particular drugs, for
instance, Naltrexone and Buprenorphine which as full and partial agonists respectively.

PHARMACOLOGY 6
What does it mean if an opioid drug is a non-ceiling drug? What side effect will increase as
the dose of opioid is increased?
If an opioid drug is a non-ceiling drug, then, there is no ceiling for the dose that can be
prescribed safely. However, higher doses increase potential side effects such as addiction and
respiratory depression.
What are the effects the nurse would expect from a drug that blocks both COX-1 and
COX-2? Which are beneficial, which are side effects?
Cyclooxygenases, COX-1 and COX-2, release prostaglandins that cause inflammation,
soreness, and pyrexia; conversely, COX-1 produces prostaglandins which activate the body’s
platelets and protects the gastrointestinal mucosal layer (Korotkova & Jakobsson, 2014). A nurse
would expect reduced inflammation, analgesia, antipyrexia, and reduced platelet aggregation.
Besides, the nurse would expect some side effects such as nausea, abdominal pain, insomnia, and
headaches.
What are advantages of a drug that is more selective for COX-2?
A drug that is more selective for COX-2 helps suppress the production of prostaglandins,
which results in suppressed inflammation, analgesia, and reduced fever (Korotkova & Jakobsson,
2014). Such drugs help reduce the effects of prostaglandins due to the action of COX-2 while
preserving the integrity of the action of COX-1; therefore, patients are less likely to suffer from
gastrointestinal toxicity and excessive bleeding (Korotkova & Jakobsson, 2014).

PHARMACOLOGY 7
Antibiotics 1&2 Discussion Questions
Define opportunistic
Opportunistic defines the condition where an organism that under normal circumstance is
harmless but may become pathogenic when a host’s immunity is compromised.
Define superinfection
Superinfection is a new infection that occurs in a patient who has a preexisting infection;
for instance, having a urinary tract infection caused by microbial agents that are resistant to the
antibiotics administered for a recent sinus infection.
What is a beta-lactamase inhibitor?
A beta-lactamase inhibitor blocks the action of beta-lactamases, which helps prevent the
degradation of beta-lactam antibiotics (Burns et al., 2015). Beta-lactamases are produced by
certain species of bacteria such as the Enterococcus species: they inactivate antibiotics
(cephalosporin and penicillin) by cleaving the beta-lactam ring (Burns et al., 2015). However,
their activity can be maintained for longer periods by combining with beta-lactamase inhibitors
such as Clavulanic acid.
Name at least three nursing interventions to reduce the development of resistant
organisms.
Antimicrobial resistance is an emerging issue in the treatment of various bacterial
infections. Nurses play a significant role in reducing the development of resistant organisms
through numerous interventions. The development of resistant microbes is a threat to the public
sector and patients’ health (Alividza, 2017). Through public education, nurses can help the
masses comprehend the sophisticated medical terms, and change their misconceptions on
antimicrobial resistance (Alividza, 2017). Besides, public participation in quality improvement

PHARMACOLOGY 8
programs helps create awareness of drug resistance. Also, the nurses advocate for proper hand
hygiene to reduce the risks of cross-contamination (Alividza, 2017). Such interventions prevent
the transmission of resistant organisms from surfaces or people.

PHARMACOLOGY 9
References
Alividza. V. (2017). Reducing drug resistance through antimicrobial stewardship strategies.
Nursing Times, 113(9), 22-25.
Burns, C. J., Daigle, D., Liu, B., McGarry, D., Pevear, D. C., TROUT, R.E.L., & Jackson, R. W.
(2015). U.S Patent No. 9,040,504. Washington, DC: U.S. Patent and Trademark Office.
DeLong, M.R., Huang, K.T., Gallis, J., Lokhnygina, Y., Parente, B., Hickey, P., … & Lad, S. P.
(2014). Effect of advancing age on outcomes of deep brain stimulation for Parkinson
disease. JAMA neurology, 71(10), 1290-1295.
Korotkova, M., & Jakobsson, P. J. (2014). Characterization of microsomal prostaglandin E
synthase 1 inhibitors. Basic & clinical phamacology & toxicology, 114(1), 64-69.
Mancia, G., & Grassi, G. (2014). The autonomic nervous system and hypertension. Circulation
research, 114(11), 1804-1814.
Nielsen, S., Lawrence, B., Degenhardt, L., Gowing, L., Kehler, C., & Lintzeris, N. (2016).
Opioid agonist treatment for pharmaceutical opioid dependent people. Cocharane
Database of Systematic Reviews, (5).
Robison, A., & Wermeling, D. P. (2014). Intranasal naloxone administration for treatment of
opoid overdose. American Journal of Health-System Pharmacy, 71(24), 2129-2135.
Sultana, J., Spina, E., & Trifiro, G. (2015). Antidepressant use in the elderly: the role of
pharmacodynamics and pharmacokinetics in drug safety. Expert opinion on drug
metabolism & toxicology, 11(6), 883-892.